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History of Mental Health. 1840’s-Dorthea Dix championed need for mental health institutions on a federal level By the 1920’s, State Hospitals were warehousing individuals who utilized them due to lack of social programs. Mental Health Reform. Early 1900’s, Mental Health Reform was started

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history of mental health
History of Mental Health
  • 1840’s-Dorthea Dix championed need for mental health institutions on a federal level
  • By the 1920’s, State Hospitals were warehousing individuals who utilized them due to lack of social programs
mental health reform
Mental Health Reform
  • Early 1900’s, Mental Health Reform was started
  • Critical of State Hospitals run by the state governments
  • WWII-Focused attention on Mental Health Issues, due to 1 out of 4 draftees being rejected from duty because of mental health or neurological issues
  • Mental Health Act of 1946-established the National Institute of Mental Health that focused on modernizing treatment approaches to psychiatric care
community health centers acts of 1963 1965
Community Health Centers Acts of 1963 & 1965
  • Act of 1963-Appropriated funds only for construction of Community Health Centers
  • Act of 1965-Staffing-Governmental proposals to institute federal programs for the aged and the poor
  • Focused on mental health prevention-a concept that was borrowed from the Public Health concept of prevention
deinstitutionalization
Deinstitutionalization
  • Nixon Administration impounded funds for mental health programs
  • Reagan Administration collapsed all mental health funding to block grants
  • Between 1970-73, 14 state hospitals had closed, with Reagan promising to close all by 1980
  • Judicial decisions impacted treatment-increased civil rights of patients, while requiring the states to provide treatment
  • States provided narrow interpretation of Donaldson decision
  • Illusory legal decisions for the mentally ill-enhancing human rights and freedoms without any corresponding improvement in services to be provided
revolving door
Revolving Door
  • High incidence of readmissions to the state hospitals and less money for treatment-medication management
  • Hospital related deaths
  • Mental health clients increase involvement to petty crime
  • By 2000, reforms change judicial policy and establish specialized courts to deal with mentally ill, non-violent offenders
community mental health centers under siege
Community Mental Health Centers under siege
  • Chronically, mentally ill population that were discharged from state hospitals prove to be a burden for the service providers
  • CMHC’s receive cut in federal funding
  • Reagan provides block grants to states, but with a 21% cut
  • Reliance on government assistance programs
  • Reorganization-increase of case loads and target of chronic mentally ill treatment
preventative committment
Preventative Committment
  • Out-patient programs have lack of follow thru by chronically mentally ill patients, but continue with increased hospitalization
  • Utilizes preventative commitment as a treatment modality to prevent decompensation of the chronically, mentally ill
  • Statue provides for mentally ill people who are unable to voluntarily comply with treatment and need treatment to prevent decompensation to be a danger to self, others, or a grave disability
mental health service delivery
Mental Health Service Delivery
  • SAMSHA-Substance Abuse and Mental Health Services Administration-oversees block grants
  • Block grants administered since 1981
  • New Approaches to treatment delivery-Capitation Method
  • Predetermined amount of money to be provided per client that insist on a wide range of services to be delivered
integrated mental health concept
Integrated Mental Health Concept
  • Categorical grants-Medicaid, Supplemental Security Income, Food Stamp Program. Local funding would be allocated to a common fund
  • Non-Profit Planning Committee-Would oversee planning and coordination, monitor performance, and evolve innovative programs
  • High-usage clients would be targeted for provision of less costly services in order to generate surpluses for less intensive programs
parity for mental health care
Parity for Mental Health Care
  • 1996-Established parity form mental health treatment
  • Employers with more than 50 employees who offer any mental health coverage, must include mental health coverage comparable to physical health coverage
  • In 2000, survey found a resulting decrease in employee benefits
substance abuse
Substance Abuse
  • High cost to society has provided much focus in social policy
  • Increase in block grants to fund programs
  • Public intolerance has escalated due to highway fatalities, HIV transmission between IV drug users, and Fetal Alcohol Syndrome and drug abuse affects among newborn infants
  • Drug-Free Schools Act of 1990-Provided $500 million for drug abuse prevention
  • Focus of treatment is mainly directed at intervention strategies and rehabilitation since there are not any major prevention initiatives
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